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In the article, a study was conducted with the aim of establishing the characteristics of hybrid ecologically safe biodegradable filled composites based on polylactide, coffee grounds and humic substances. Hybrid ecologically safe biodegradable filled composites were obtained by extruding pre-prepared polylactide, coffee grounds and humic substances in a single-screw laboratory extruder at a temperature of 170–200 °C and a roll rotation speed of 30–100 rpm. When obtaining hybrid ecologically safe biodegradable filled composites, lactic acid polylactide polymer of the extrusion brand Terramac TP-4000 was used. Waste coffee grounds collected in 8 different coffee shops in the city of Kharkiv and dried to a moisture content of 0,5 % were used. Humic substances were used as hybrid modifiers. It was established that the hybrid modification of highly filled polylactide-coffee grounds systems with humic derivatives of lignite in the form of humic substances allows to significantly increase the main strength characteristics. It was established that there is a 2.5-fold increase in impact toughness and destructive bending stress during hybrid modification of environmentally safe biodegradable filled composites based on polylactide, coffee grounds, and humic substances, while the optimum from the point of view of strength characteristics is the content of coffee grounds at the level of 50 % by weight and 0.5 % wt. humic substances. For such hybrid ecologically safe biodegradable filled composites based on polylactide, coffee grounds and humic substances, the melting flow rate is characteristic at the level of 3.1 g/10 min. and the processing temperature range is 182–188 °С. It was also established that hybrid modification in the framework of obtaining hybrid ecologically safe biodegradable filled composites based on polylactide, coffee grounds and humic substances with a content of 0.5 % by mass. different types of humic substances in them and different contents of coffee grounds allow them to preserve biodegradation properties for 6 months.

Papryka ostra należy do roślin uprawianych z rozsady przygotowywanej w doniczkach. W przeprowadzonym doświadczeniu prześledzono wpływ uproszczonych sposobów przygotowania rozsady na plonowanie trzech polskich odmian papryki ostrej: Bronowicka Ostra, Orkan, Rokita. Zastosowano cztery sposoby produkcji rozsady: doniczkopalety stożkowe; doniczkopalety okrągłe; doniczki pojedyncze z dwoma siewkami; doniczki pojedyncze z jedną siewką. Uzyskany plon handlowy wskazuje na przydatność doniczkopalet stożkowych i okrągłych do produkcji rozsady papryki, które zapewniają mniejsze o 50% zużycie podłoża w porównaniu z doniczkami pojedynczymi. Nieracjonalne jest przygotowanie rozsady w doniczkach pojedynczych z dwiema roślinami ze względu na nieadekwatną zwyżkę plonu i wykorzystanie dwukrotnie większej liczby nasion. Sposób przygotowania rozsady nie decydował o zawartości oznaczanych składników chemicznych. Oceniane odmiany nie różniły się plonem handlowym owoców. Wykazano natomiast istotne zróżnicowanie między ocenianymi odmianami w zawartości w owocach suchej masy (%), kwasu L-askorbinowego (mg·100 g–1), cukrów ogółem (g·100 g–1), oraz kapsaicyny (%).

Rethinking cities in a more sustainable and integrated way is a key opportunity for successful climate change adaptation and mitigation. Nature-based solutions and green infrastructures can help to safeguard urban nature and biodiversity while providing multiple benefits to reduce climate risks and improving human well-being. Nature-based solutions help to mitigate flood risk by regulating storm-water runoff and peak-flow. This paper investigates the effects of nature-based solutions and green infrastructure networks on pluvial flood risk in Milan metropolitan area in terms of direct economic damage to buildings and population exposed. Results show that extended urban green networks can reduce pluvial flood damages (by up to 60%) and the population exposed (up to 50%). For all analysed rainfall intensities, damages to buildings and share of population exposed decrease as green area coverage increases, with slightly higher risk reduction for lower-intensity events. 25% of additional urban green coverage can halve the expected annual damage and reduce by 40% the expected annual population exposed. The applied methodological framework makes it possible to identify priority-action urban areas and hence inform decision-making processes as for where green solutions are most efficient.

Ecosystems and ecosystem services may contribute to reduction in disaster risk, sustainable development and climate change adaptation. The potential of Nature-based Solutions (NbS) is now recognized by major national policies and international framework agreements. However, to date there is limited scientific evidence about their economic viability and equity impacts. In this study we developed a global database of 406 observations from 87 peer-reviewed studies published between 2000 and 2020, completing economic evaluations of NbS for Ecosystem-based Climate Adaptation (EbA) and Ecosystem-based Disaster Risk Reduction (Eco-DRR). We examine available scientific knowledge on the economic viability and performance of NbS for Eco-DRR and EbA, both in terms of efficiency and equity. More than 40% of the studies analyze the role of coastal ecosystems, coral reefs, wetlands, and mangroves in attenuating disaster risk, with a special focus on floods, storms and erosion. Abundant are also studies examining forest ecosystems (30%), followed by urban (25%) and riparian ecosystems (23%). A smaller number of studies analyzes agro-ecosystems. The number of studies per region suggests that Europe, Asia, and North America are the regions where most Eco-DRR research was undertaken. Based on our results, 71% of studies found that the ecosystems studied were effective NbS in mitigating hazards. 24% of studies found that the ecosystems were occasionally effective in mitigating hazards. None of the studies found NbS ineffective in mitigating hazards. The ecosystems most frequently effective in mitigating hazards included mangroves (80%), forests (77%), and coastal ecosystems (73%). A subset of studies compared the efficacy and cost-effectiveness of NbS and engineering-based solutions in mitigating certain hazards (39%). Among these studies, 65% found that NbS are always more effective in attenuating hazards compared to engineering-based solutions, and 26% found that NbS are partially more effective. No study found that NbS are less effective than engineering-based solutions.

Climate change is projected to increase the frequency and intensity of future droughts particularly affecting the most low-income countries directly dependent on local rainfed food security and livelihoods. Drought risk and its related impacts depend on the drought hazard, the exposure and the vulnerability of the different socioeconomic sectors and/or ecosystems as well as the adaptive capacity of affected locations. The Horn of Africa, which includes Ethiopia, is currently experiencing one of the most severe droughts in the last 40 years. This study applies a storyline approach to investigate changes in drought risk for Ethiopia combining vulnerability, hazard and adaptive capacity information for current and future projected climatic and socio-economic conditions using a subnational level composite indicator. For our analysis, we define drought based on the Standardised Precipitation-Evapotranspiration Index (SPEI) which characterises the deficits in local water availability based on the precipitation and potential evapotranspiration. SPEI is computed using bias corrected Inter-Sectoral Impact Model Intercomparison Project (ISIMIP) project based on the Coupled Model Intercomparison Project Phase 6 (CMIP6). The Drought vulnerability assessment is carried out combining exposure, adaptive capacity and sensitivity indicators, using INFORM index developed by the Joint Research Centre of the European Commission to support humanitarian crisis and disaster decision-making. The analysis shows that future drought will increase people in need of food assistance both under current population and future population projections. If humanitarian aid and assistance are maintained at recent historical levels, these findings show a substantial increase in the required amounts. These conditions are exasperated when humanitarian access is impeded by local conditions such as the current conflict in Ethiopia, when imports are reduced by crises such as those associated with the Russian invasion of the Ukraine, and by pandemics such as COVID-19. Climate change mitigation is shown to reduce the vulnerability of Ethiopia through a reduction in drought hazard frequency and intensity. The framework presented in this study can be used as a policymaking tool to provide information on how to better prioritize future loss and damage funds and adaptation and mitigation investments to reduce population vulnerability and exposure.

The global economic loss caused by weather-related extreme events amounts to over $260 billion in 2022. Storms and floods are among the deadliest disasters and are responsible for the highest toll. Despite committed research efforts in strengthening flood forecasting and making those predictions readily and openly available, much remains to be done to facilitate intervention when locally acting upon those forecasts. This research aims at building an automated tool to forecast flood direct damages with a high spatial resolution and timeliness. Thus, allowing prompt, informed and targeted early action on site before the disaster hits. Moreover, it can serve as a device to unravel criticalities within preparedness plans and guide the adoption of adaptation measures in the long term. The proposed research develops a tool to rapidly link GLOFAS discharge forecasts with the relative inundation map and direct damages caused. The method includes three modules: i) a factual component collecting satellite-derived flood maps of historical events; ii) a probabilistic component based on hydrological modelling and iii) the impact assessment. The past event database comprises 10-meter resolution inundation maps derived from Sentinel-1 SAR imagery with a single-scene automated classification method. The outcome of hydrological modelling is then integrated with the remote sensing database to improve its accuracy and spatial resolution. Lastly, the impact assessment module estimates affected people and the economic damage to buildings. The presented methodology is applied to two case studies: the flooding caused by Tropical Cyclone Idai that made landfall in March 2019 in Mozambique and the country-wide flood event that occurred in Pakistan in the summer of 2022.

Over the past 20 years, the CATDAT disaster database has been collected using various research, government and private sector sources in order to examine the social and economic impacts of disasters globally and has been used extensively in the media both in post-disaster comparisons, as well as a standalone. To aid the understanding of what disaster damages and losses actually entail, as well as to reduce the amount of miscommunication in the media, a new style of outreach is being used where a database for the European part of CATDAT is being improved and released over a number of years (2021-2026). For Europe, the EEA-CATDAT database (https://www.eea.europa.eu/ims/economic-losses-from-climate-related) is presented which takes into account weather and climate-related extreme events in addition to geophysical events. Over a 5-year period, a combination of updates to the database have been and will be implemented such as public outreach programs/workshops to understand better what is counted in disasters, how to combine together the socio-economic effects of multiple disasters properly, and where these events were actually located (i.e. including the footprints of historical events). In addition, the commonly made errors in databases such as wrong event times, transcript errors in socioeconomic losses, faulty economic and social indicators for comparison, inflation and normalisation problems, language errors, and most importantly the different damage and loss definitions used across the EU, will be detailed and simplified for the understanding of the general public such as the differences between insurance, private sector and government estimates. Using lessons learned from the last 10 years of science communication of CATDAT to the world, it is hoped that by undertaking such a communication effort, that errors in the media and scientific publications will be reduced. In addition, we hope that disaster damages and losses will be understood better including their trends; and that indeed governments, dataviz scientists and journalists as well as researchers will be able to benefit from the knowledge including in the MYRIAD-EU project on multi-hazard risk scenarios for Europe.

Research on investigation of hybrid eco-friendly polymers modificated by humic substances are given in this article. The purpose of the research is to investigate a hybrid modification of eco-friendly polymers of polylactic acid by humic substances, it was found that the mechanism of hybrid modification in the matrix synthesis of the polylactic acid-humic substances system indicates an intermolecular bond between polylactic acid and humic substances, at the same time, due to increased crystallization and the emergence of intermolecular and ester bonds in the formation of more rigid mesh structure in the system polylactic acid-humic substances is increasing the mechanical properties of such materials. It was found that the increase in the impact strength and the breaking stress during bending in the polylactic acid-humic substances system in the hybrid modification occurs, while the optimal content of humic substances in the polylactic acid-humic substances systems is 0.5 % by mass.

Cardiovascular disease (CVD) is associated with intestinal barrier dysfunction and increased intestinal permeability. Increased intestinal permeability to gut microbial metabolites may accelerate the progression of CVD. Plasma citrulline levels are a marker of functional enterocyte mass, and reduced citrulline levels indicate intestinal epithelial damage. Citrulline was reported as a useful prognostic marker in critically ill patients. However, data are lacking on the association of citrulline with long-term mortality in patients with CVD and with the levels of trimethylamine N-oxide (TMAO), a microbiota-derived metabolite which has been implicated in the pathogenesis of CVD.To assess the effect of citrulline levels, a marker of intestinal barrier disruption, on long-term mortality in patients with CVD. Moreover, the relationship between the concentrations of 2 biomarkers - citrulline and TMAO - was assessed.Serum citrulline levels were retrospectively assessed in 1036 consecutive patients with CVD (median age: 62 years; 61% men) hospitalized between 2013 and 2015. Associations of citrulline levels with 5-year mortality rates as well as anthropometric and biochemical parameters were evaluated for the entire study group and in subgroups of patients with acute coronary syndrome (ACS), chronic coronary syndrome, chronic heart failure (chronic HF), and atrial fibrillation (AF). Correlations between serum citrulline and TMAO levels were assessed.The median citrulline level in the study population was 22.5 μM (interquartile range (IQR): 17.8-27.9). Citrulline levels were not associated with 5-year mortality in patients with CVD (hazard ratio (HR) = 0.99; 95% confidence interval (95% CI): 0.97-1.00; p = 0.49). Median citrulline levels differed significantly between deceased patients and survivors at 5 years in patients with ACS (p = 0.025). There were no significant correlations between citrulline and TMAO levels (Kendall's tau = 0.027).Decreasing citrulline levels do not predict long-term mortality of hospitalized patients with CVD. Moreover, they are not associated with the serum levels of TMAO in these patients.

The combined effect of global sea level rise and local subsidence phenomena poses a major threat to coastal settlements. Flooding events are expected to grow in frequency and magnitude, increasing the potential economic losses and costs of adaptation. In Italy, a large share of the population and economic activities are located along the coast of the peninsula, although risk of inundation is not uniformly distributed. The low-lying coastal plain of Northeast Italy is the most sensitive to relative sea level changes. Over the last half a century, the entire north-eastern Italian coast has experienced a significant rise in relative sea level, the main component of which was land subsidence. In the forthcoming decades, sea level rise is expected to become the first driver of coastal inundation hazard. We propose an assessment of flood hazard and risk linked with extreme sea level scenarios, both under historical conditions and sea level rise projections at 2050 and 2100. We run a hydrodynamic inundation model on two pilot sites located in the North Adriatic Sea along the Emilia-Romagna coast: Rimini and Cesenatico. Here, we compare alternative risk scenarios accounting for the effect of planned and hypothetical seaside renovation projects against the historical baseline. We apply a flood damage model developed for Italy to estimate the potential economic damage linked to flood scenarios and we calculate the change in expected annual damage according to changes in the relative sea level. Finally, damage reduction benefits are evaluated by means of cost-benefit analysis. Results suggest an overall profitability of the investigated projects over time, with increasing benefits due to increased probability of intense flooding in the next future.

The topic of multiple hazards at sites has been in the mainstream for the past 50 years within Europe, however most studies have focussed on only a few key independent hazards and have been mostly limited to either buildings, specific sites like nuclear power plants or large scale studies. Less emphasis has been put on the application of these multiple hazards on particular sectors, and even less research has been done on the application of dependent hazard combinations. The use of stochastic event sets or empirical data for natural peril events provide a useful basis to determine potential pairs or group events affecting a site, however the interactions with the built infrastructure and even further to the socio-economic interactions in a sector such as tourism are usually very difficult to quantify. Companion abstracts present empirical data overlaps (Claassen et al.) and the stochastic event sets and probabilistic outputs (Schaefer et al.) in this EGU23. End-to-end independent and dependent scenarios are tested for a key sector, tourism, at various MYRIAD-EU test case sites, in order to examine which combinations merit quantitative, semi-quantitative or qualitative risk scenario methods. Quantitative and qualitative solutions are needed depending on the hazard combination, modellability, uncertainties and vulnerability and exposure feedbacks throughout the risk chain and risk metrics being examined. This is an extension from the work of the NARSIS project for nuclear power plants where a multi-hazard framework was used for sites across Europe. The use of the EEA-CATDAT database (also a separate abstract in EGU23) is made in order to look at the historical impacts of empirical events are examined which have affected the tourism sector for the Canary Islands, Veneto and the Danube region in order to gain insights into the depth of multi-hazard analyses required to properly understand an event impact chain. In addition, external and simultaneous factors such as COVID-19 and/or other health events, wars and shocks are also examined. This work is envisaged to be able to be used in Europe and potentially extended globally.

Introduction: Trimethylamine N-oxide (TMAO) is an organic compound with a well-established involvement in the pathogenesis of cardiovascular disease (CVD). However, data on the links between TMAO levels and cardiovascular mortality in Polish patients are lacking. Objectives: We aimed to assess the relationship between serum TMAO levels and 5-year mortality in Polish patients with CVD. Patients and Methods: We retrospectively assessed serum TMAO levels in 1,036 consecutive patients (median age, 62 years; men, 61%) hospitalized between 2013 and 2015. Correlations between TMAO levels and 5-year mortality as well as anthropometric and biochemical parameters were assessed for the whole population and the subgroups of patients with acute coronary syndrome, stable coronary syndrome (SCS), chronic heart failure (HF), and atrial fibrillation (AF). Results: In the univariate analysis, increased TMAO levels predicted 5-year mortality without clinically significant power (hazard ratio [HR], 1.01; 95% CI: 1.006–1.018; p < 0.0001). However, even this weak effect was lost in the multivariate analysis after adjustment for age, sex, comorbidities, and laboratory parameters. In the whole study group, TMAO levels in the fourth quartile of concentration (>6.01 µM) predicted 5-year mortality only in the univariate analysis (HR: 1.55; 95% CI: 1.34–1.79; p < 0.0001). In subgroup univariate analysis, TMAO levels predicted 5-year mortality in patients with SCS, chronic HF, and AF. Conclusions: Despite the promising results of previous studies, our study shows that the level of TMAO has at most moderate value in predicting all-cause mortality. TMAO levels depend on other clinical variables, which limits the use of TMAO as an independent predictor of mortality in these patients.

The article presents the main principles of English-Welsh land law, connected to protection of real estate transactions, based on land registration. The main aim is to research similarities and differences of this regulation with the three major principles of Torrens system formulated by T. Rouff – the mirror principle, the curtain principle and the insurance principle.

Calculating impacts from climate projection ensembles can be challenging. A simple approach might consider just the ensemble mean, but this ignores much of the information in the ensemble and does not explore the range of possible impacts. A more thorough approach would consider every ensemble member, but may be computationally unfeasible for many impact models. We investigate the compromise in which we represent the ensemble by the mean and a single deviation from the mean. The deviation from the mean would ideally be representative both of variability in the ensemble, and have a significant impact, according to some impact metric. We compare methods for calculating the deviation from the mean, based on traditional compositing and a statistical method known as Directional Component Analysis (DCA). DCA is based on linearizing the impact metric around the ensemble mean. We illustrate the methods with synthetic examples, and derive new mathematical results that clarify the interpretation of DCA. We then use the methods to derive scenarios from the UKCP18 and EURO-CORDEX projections of future precipitation in Europe. We find that the worst ensemble member is not robust, but that deviations from the ensemble mean calculated using compositing and DCA are robust. They thus give robust insight into the patterns of change in the ensemble. We conclude that mean and representative deviation methods may be suitable for climate projection users who wish to explore the implications of the uncertainty around the ensemble mean without having to calculate the impacts of every ensemble member.

Deliverable 1.1 ‘Wiki-style online crowdsourcing platform of multi-risk methods, models, and tools’ is associated with Task 1.2 ‘Review of methods, models and tools for multi-hazard, multi-risk management’ of work package 1 ‘Diagnosis’ of the MYRIAD-EU project. The aim of the task was to develop a Wiki-style online crowdsourcing platform of examples of qualitative and quantitative multi-hazard, multi-risk methods, models, and tools (approaches), including examples of their application. The purpose of D1.1 is to serve as an information resource and starting point in our laboratory of systemic multi-hazard risk assessment and management. The Disaster Risk Gateway wiki was developed using a mixed-methods approach, including traditional literature reviews and data gathering exercises, combined with participatory activities and data collection forms. The development of the wiki was divided into initial scoping work carried out between September 2021 and January 2022, that was followed by the creation of the online website, including content creation between February and October 2022. The scoping work focused on generating interest and input across the consortium; setting boundaries on the scope and functionality of the wiki; collecting examples of existing approaches, particularly their implementation in mapping out the wiki structure; undertaking an initial scoping of existing literature to design the review task; and exploring and discussing previous or existing wikis to determine the best approach. The wiki design, development, and deployment were undertaken by BGS. It was created using the freely available software, MediaWiki, which is designed for open content, and is hosted by the BGS. Functionality and the appearance of the wiki has been customised through the installation of extensions that are attached to the core software. The wiki has a nested structure and pages are responsive allowing for page optimisation across all devices. The outcome of the scoping work informed the design and structure of the wiki, with the current content classified into two main categories: ‘multi-hazard risk assessment’ and ‘multi-hazard risk management’. In addition to overviews of multi-hazard risk assessment and management approaches, the wiki also contains definitions for key terms. These definitions are sourced from the MYRIAD-EU WP1 deliverable D1.2 ‘Handbook of Multi-hazard, Multi-Risk Definitions and Concepts’. The integration of the wiki into the Dashboard (WP2, Task T2.3) ensures access to the MYRIAD-EU products and services synchronously with key approaches from previous and ongoing external projects. The Disaster Risk Gateway will continue to develop dynamically over time as more content is crowdsourced and new content sub-categories are created by the wiki team. The Disaster Risk Gateway is available at www.disasterriskgateway.net. The WP1 team would like to acknowledge all the contributions of the consortium on this task and the BGS Intellectual Property, Legal, and Enquiry Services for their support in delivering this work.

Beginning with the various strategies of the SARS-CoV-2 virus to invade our bodies and manifest infection, and ending with the recent long COVID, we are witnessing the evolving course of the disease in addition to the pandemic. Given the partially controlled course of the COVID-19 pandemic, the greatest challenge currently lies in managing the short- and long-term complications of COVID-19. We have assembled current knowledge of the broad spectrum of cardiovascular, pulmonary, and neuropsychiatric sequelae following SARS-CoV-2 infection to understand how these clinical manifestations collectively lead to a severe form of the disease. The ultimate goal would be to better understand these complications and find ways to prevent clinical deterioration.

This report is the first output of Work Package 1: Diagnosis of the MYRIAD-EU project: Handbook of Multi-hazard, Multi-Risk Definitions and Concepts. The aim of the task was to (i) acknowledge the differences and promote consistency in understanding across subsequent work packages in the MYRIAD-EU project, (ii) improve the accessibility of our work to a broad array of stakeholders and (iii) strengthen consensus across the hazard and risk community through a common understanding of multi-hazard, multi-risk terminology and concepts. The work encompassed a mixed-methods approach, including internal consultations and data-generating exercises; literature reviews; external stakeholder engagement; adopting and building on a rich existing body of established glossaries. 140 terms are included in the glossary, 102 related to multi-hazard, multi-risk, disaster risk management and an additional 38 due to their relevance to the project, acknowledging the need for a common understanding amongst an interdisciplinary project consortium. We also include extended definitions related to concepts particularly of relevance to this project deliverable, including ‘multi-hazard’, ‘hazard interrelationships’, ‘multi-risk’ and ‘direct and indirect loss and risk’. Underpinned by a literature review and internal consultation, we include a specific section on indicators, how these might be applied within a multi-hazard and multi-risk context, and how existing indicators could be adapted to consider multi-risk management. We emphasise that there are a number of established glossaries that the project (and risk community) should make use of to strengthen the impact of the work we do, noting in our literature review a tendency in papers and reports to define words afresh. We conclude the report with a selection of key observations, including terminology matters – for all aspects of disaster risk management, for example communication, data collection, measuring progress and reporting against Sendai Framework targets. At the same time, we discuss when is it helpful to include ‘multi-‘ as a prefix, questioning whether part of the paradigm shift needed to successfully address complex challenges facing an interconnected world is through inherently seeing vulnerability, exposure and disaster risk through the lens of multiple, interrelated hazards. We emphasise that there is likely to be an evolution of the terminology throughout the project lifetime as terms are emerge or shift as the project evolves. Finally, we propose a roadmap for developing and testing draft multi-risk indicators in MYRIAD-EU. The WP1 team would like to acknowledge all the contributions of the consortium on this task and the feedback from the External Advisory Board, in particular the chair of the board Virginia Murray, Head of Global Disaster Risk Reduction at the UK Health Security Agency, and the contribution of Jenty Kirsch-Wood, Head of Global Risk Management and Reporting at UNDRR, for her reflections on the findings of this work.

Climate change and rapid expansion of urban areas are expected to increase pluvial flood hazard and risk in the near future, and particularly so in large developed areas and cities. Therefore, large-scale and high-resolution pluvial flood hazard mapping is required to identify hotspots where mitigation measures may be applied to reduce flood risk. Depressions or low points in urban areas where runoff volumes can be stored are prone to pluvial flooding. The standard approach based on estimating synthetic design hyetographs assumes, in a given depression, that the T-year design storm generates the T-year pluvial flood. In addition, urban areas usually include several depressions even linked or nested that would require distinct design hyetographs instead of using a unique synthetic design storm. In this paper, a stochastic methodology is proposed to address the limitations of this standard approach, developing large-scale ∼ 2 m-resolution pluvial flood hazard maps in urban areas with multiple depressions. The authors present an application of the proposed approach to the city of Pamplona in Spain (68.26 km2). The Safer_RAIN fast-processing algorithm based on digital elevation models (DEMs) is compared with the IBER 2D hydrodynamic model in four real storms by using 10-min precipitation fields. Precipitation recorded at rainfall-gauging stations was merged with continuous fields obtained from a meteorological radar station. Given the hydrostatic limitations of Safer_RAIN, the benchmarking results are adequate in terms of water depths in depressions. A long set of 10 000 synthetic storms that maintain the statistical properties of observations in Pamplona is generated. Safer_RAIN is used to simulate runoff response, and filling and spilling processes, in depressions for the 10 000 synthetic storms, obtaining the probability distribution of water depths in each cell. Maps of pluvial flood hazards are developed in the Pamplona metropolitan area for 10 return periods in the range from two to 500 years from such pixel-based series of simulated water depths. Bivariate return-period curves are estimated in a set of cells, showing that several storms can generate a given T-year pluvial flood with an increasing precipitation with storm duration that depends on the draining catchment soil characteristics. The methodology proposed is useful to develop maps of pluvial flood hazards in large multi-depression urban areas in reasonable computation times, identifying the main pluvial flood hotspots.

Probabilities of future climate states can be estimated by fitting distributions to the members of an ensemble of climate model projections. The change in the ensemble mean can be used as an estimate of the change in the mean of the real climate. However, the level of sampling uncertainty around the change in the ensemble mean varies from case to case and in some cases is large. We compare two model-averaging methods that take the uncertainty in the change in the ensemble mean into account in the distribution fitting process. They both involve fitting distributions to the ensemble using an uncertainty-adjusted value for the ensemble mean in an attempt to increase predictive skill relative to using the unadjusted ensemble mean. We use the two methods to make projections of future rainfall based on a large data set of high-resolution EURO-CORDEX simulations for different seasons, rainfall variables, representative concentration pathways (RCPs), and points in time. Cross-validation within the ensemble using both point and probabilistic validation methods shows that in most cases predictions based on the adjusted ensemble means show higher potential accuracy than those based on the unadjusted ensemble mean. They also perform better than predictions based on conventional Akaike model averaging and statistical testing. The adjustments to the ensemble mean vary continuously between situations that are statistically significant and those that are not. Of the two methods we test, one is very simple, and the other is more complex and involves averaging using a Bayesian posterior. The simpler method performs nearly as well as the more complex method.

Background Ticagrelor and prasugrel are widely used as antiplatelet therapy after coronary angioplasty. However, there is a group of patients with indications for clopidogrel treatment. This population includes patients with chronic or acute coronary syndrome who are treated invasively and have contraindications to the use of novel antiplatelet drugs due to antithrombotic treatment (particularly with non-vitamin K antagonist oral anticoagulants). A wide range of generic forms of clopidogrel are available on the market. However, it is unclear whether they are as effective as the originator drug. Objectives In the current study, we aimed to assess the concentrations of the active metabolite of clopidogrel and its effect on platelet aggregation inhibition in patients receiving the originator drug in comparison with those receiving generic clopidogrel. Material and methods We enrolled 22 healthy individuals without polymorphisms in the ABCB1 gene and the allele variants CYPC19*2 and CYPC19*3. All participants received a loading dose of clopidogrel (600 mg), followed by a maintenance dose of 75 mg for the next 3 days. On day 3, blood samples were obtained 1 h after drug administration to assess active metabolite concentrations using liquid chromatography with tandem mass spectrometry. In each participant, platelet aggregation was assessed with light transmission aggregometry after 5-μmol/L and 10-μmol/L adenosine diphosphate (ADP) stimulation. Assays were performed for the originator clopidogrel and 2 different generic groups. Results The mean ± standard deviation (SD) concentrations of active clopidogrel did not differ between the originator drug and 2 generic products with clopidogrel (12.7±5 pg/μL compared to 13.0 ±4 pg/μL compared to 14.4 ±4 pg/μL). Platelet aggregation inhibition after stimulation with 5 μmol/L and 10 μmol/L ADP was similar for all preparations. Conclusions In comparison with original clopidogrel, the use of its generic form does not affect the blood concentrations of the active metabolite or its antiplatelet effect.

Pluvial flooding is a major concern in urban environments with limited or temporarily reduced efficiency of surface drainage. Climate change, land use change, and increased exposure in hazard prone areas play a role in increasing pluvial flood risks. We describe a methodology for rapid probabilistic pluvial flood hazard mapping and risk assessments in urban environments developed for the Copernicus Climate Change Service “Pluvial Flood Risk Assessment in Urban Areas” demonstrator project for large computational domains. The methodology is designed to be flexible and robust enough to be adapted to other cities in Europe and elsewhere, and is composed of three main steps: (i) computation of the intensity–frequency relationship to express the depth of extreme hourly rainfall events at the urban scale; (ii) characterization of the pluvial flood hazard by means of raster-based flood modeling, and; (iii) estimation of the direct tangible damages at the building level for residential, commercial, and industrial buildings. Methods are tested for 20 cities across Europe and considering two infiltration rate scenarios. Spatial-explicit results at the urban-scale highlight the neighborhoods and sub-urban areas more adversely affected in terms of direct tangible damage to buildings and assets. Probabilistic risk assessment results indicate that Brussels, Antwerp, and London are the cities with higher expected annual damages per built-up area among the 20 cities considered in this study. These results can be useful for supporting the implementation of the Sendai Framework for DRR 2015–2030, for developing multi-hazard risk assessments, and for supporting the development of national climate change adaptation plans.

Background Platelets are key players in hemostasis. These blood cells contain different types of granules. Recently, there has been a growing interest in the role of inorganic polyphosphate (polyP) structures stored in dense granules of platelets and secreted during platelet activation. Objectives To measure platelet polyP levels in patients with thrombocytopenia and thrombocythemia, and to examine the relationship of this indicator with platelet aggregation. Material and methods The study included 36 patients with hematological disorders (26 with primary chronic thrombocytopenia and 10 with essential thrombocythemia (ET)) and 40 healthy subjects. Platelet reactivity was measured using whole blood impedance aggregometry. The polyP levels were isolated from lysed platelets, which were obtained from citrated platelet-rich plasma. The procedure included inactivating endogenous phosphatases, removing phosphate units derived from DNA and proteins, and finally hydrolyzing them into monophosphate units. A colorimetric assay using malachite green and ammonium molybdate was performed in order to quantify polyP levels. Results The polyP concentrations were significantly higher in the patients with thrombocytopenia than in the patients with thrombocythemia or the controls. The polyP level was not correlated with the level of aggregation. Conclusions The higher polyP levels observed in the patients with low platelet counts may indicate the existence of a compensatory mechanism that prevents excessive bleeding in such patients. Our study provides evidence of an essential role of polyP in platelet function and the coagulation process.

The Covid-19 coronavirus pandemic has caused changes in all areas of human life. The field of law is no exception to this list. In particular, the issues of conducting other people’s affairs without a power of attorney have become especially relevant, as social distancing and restrictions on social activity have led to a significant increase in the practical need for the application of this legal institution. The significance of this study is also important in connection with the comparative analysis of the normative aspect and the practical measurement of the application of the institute of conducting other people’s affairs without a power of attorney in Ukraine and Poland. These two countries are comparable in territory, number of citizens, legal tradition, but Poland has become member of the European Union, while Ukraine has remained on the sidelines of European civilization. The dialectical method, the method of comparative analysis and system analysis were chosen as the methodological basis of the research. The authors of the article concluded that institute of conducting other people’s affairs without a power of attorney is characterized by an increased level of social utility. In such cases, the one who protects the interests of others without a power of attorney, as a rule, acts not only in the interests of the individual but also in the interests of the society. Thus, it helps to protect single people, the elderly ones, disabled individuals and other groups which are socially unprotected and thus prevent the pandemic spread.

Ecosystems and ecosystem services are key to helping achieve reduction in disaster risk, sustainable development, and climate change adaptation, and this is now recognized by major international framework agreements (Convention on Biological Diversity, 2014; United Nations Office for Disaster Risk Reduction, Sendai Framework for Disaster Risk Reduction, 2015-2030). However, there is limited knowledge about the cost efficiency and socio-economic equity outcomes of Nature-based Solutions (NbS) compared to traditional engineered strategies.In this study we developed a global database of more than 130 peer-reviewed studies, published between 2000 and 2020, that perform economic evaluations of NbS for Ecosystem-based Climate Adaptation (EbA) and Ecosystem-based Disaster Risk Reduction (Eco-DRR). Using meta-analysis techniques, we assess the existing scientific knowledge on the economic viability and performance of NbS for Eco-DRR and EbA, cataloguing outcomes both in terms of degree of economic efficiency and social equity. Our analysis includes multiple dimensions: geographic distribution of the published studies, types of ecosystems and ecosystem services evaluated, hazards and climate impacts analyzed, and economic methodologies used to perform economic efficiency evaluations (e.g., cost benefit analysis, stated/revealed preferences evaluation methods).This study builds on a recent global assessment (Sudmeier-Rieux et al, 2021) that performs the first systematic review of Eco-DRR peer-reviewed studies across all disciplines. Their results show robustness of evidence and level of agreement on the role of ecosystems in attenuating 30 types of hazards, based on the assessment methodology established by the Intergovernmental Panel on Climate Change (IPCC). Our meta-analysis expands the 2021 review by evaluating the economic benefits associated with Eco-DRR and NbA approaches; by examining cost efficiency of Eco-DRR and NbA interventions compared to traditional engineering solutions; by performing equity assessments of the outcomes; and by studying how the NbS interventions reviewed contributed to the sustainable development goals (SDGs).REFERENCE:Sudmeier-Rieux, K., Arce-Mojica,T., Boehmer, H.J., Doswald, N., Emerton, L., Friess, D.A., Galvin, S., Hagenlocher, M., James, H., Laban, P., Lacambra, C., Lange, W., McAdoo, B.G., Moos, C., Mysiak, J., Narvaez, L., Nehren, U., Peduzzi, P1., Renaud, F.G., Sandholz, S., Schreyers, L., Sebesvari, Z., Tom, T., Triyanti, A., van Eijk, P., van Staveren, M., Vicarelli, M., Walz, Y. "Scientific evidence for ecosystem-based disaster risk reduction." Nature Sustainability (2021): 1-8.

The economic loss associated with natural hazards has drastically increased over the past decades, reaching over $210 billion dollars worldwide in 2020. The explication of regional-scale climate change effects with the tendency to exacerbate local climate criticalities has long jeopardized disaster resilience and the coping capacity of many communities. There is a lack of a robust operational linkage between the pre-disaster and post-disaster segments when a disaster occurs. This hampers an effective emergency response often leading to delayed humanitarian intervention and unplanned evacuations. Moreover, the great amount of openly available impact information on past events is commonly discarded and the forecast potential which the data yields has yet to be fully explored. In this context, the Impact-based Forecasting (IbF) approach aims to interconnect pre-emptive planning for early action with post-disaster impacts while taking advantage of historical data. The underlying principle of IbF is that the magnitude of an event is translated to site-specific impact information. Therefore, a paradigm shift from the conventional magnitude-likelihood relationship to impact-likelihood is proposed. This research develops a method to fully exploit the potential of IbF while overcoming the typical site-specificity of emergency response through remote sensing and automation. While the IbF framework allows for a multi-hazard approach, here we present a method targeting the ex-ante impact assessment of riverine floods. The analysis consists of two main components: i) the delineation of the flood extent from Sentinel-1 SAR imagery and ii) the definition of the event impact on the population, land and built environment. The IbF impact-likelihood relationship is ultimately derived by matching the two components for a historical event series. A fully automated Google Earth Engine algorithm for flood extent mapping with a 10 m spatial resolution has been developed to detect floodwater with a single-scene classification based on an automated thresholding method. The flood magnitude is then matched with open-access geodata such as human settlements, population density, land cover and infrastructure from the OpenStreetMap catalogue to generate the impact assessment. Once trained on several site or region specific past events, it can automatically forecast the impact associated with a given event magnitude. Here we apply the technique to three case studies including the flooding associated with the Tropical Cyclone Idai, which made landfall in Mozambique in March 2019 causing over 1200 fatalities and $2 billion worth of damage. The performance of the flood mapping algorithm has been evaluated as satisfactory for the impact application and further validation at two additional sites is ongoing. Therefore, local triggers can be set to ensure a valuable temporal window to promptly plan and estimate the cost of intervention on the field. This work is a first step to providing a consistent and regionally transferable disaster preparedness tool that allows for multi-hazard impact forecasts.

Background: Contemporary antiplatelet treatment in acute myocardial infarction (AMI) is based on one of two P2Y12 receptor inhibitors, prasugrel or ticagrelor. The aim of this study was to compare diurnal variability of platelet reactivity between patients receiving prasugrel and ticagrelor during the initial phase of maintenance treatment after AMI. Methods: It was a prospective, two-center, pharmacodynamic, observational study. Blood for platelet testing was sampled at four time points on day four after AMI (8:00, 12:00, 16:00, 20:00). Diurnal variability of platelet reactivity was expressed as a coefficient of variation (CV) of the above-mentioned measurements. Results: 73 invasively-treated patients were enrolled (ticagrelor: n = 47, prasugrel: n = 26). CV was greater in patients treated with ticagrelor compared with prasugrel according to a VASP assay (47.8 [31.6–64.6]% vs. 21.3 [12.9–25.5]%, p < 0.001), while no statistical differences were detected when the CVs of platelet aggregation according to Multiplate were compared between ticagrelor- and prasugrel-treated patients. Ticagrelor-treated patients showed more pronounced platelet inhibition than prasugrel at 16:00 and 20:00 (VASP16:00: 20.6 ± 15.0 vs. 24.9 ± 12.8 PRI, p = 0.049; VASP20:00: 18.6 ± 17.7 vs. 26.0 ± 11.7 PRI, p = 0.002). Conclusions: Ticagrelor shows greater diurnal variability in platelet aggregation than prasugrel during the initial maintenance phase of AMI treatment, and this is due to the continuous increase of platelet inhibition after the morning maintenance dose. Both drugs provide an adequate antiplatelet effect early after AMI. Evaluation of the clinical significance of these findings warrants further investigation.

Significance StatementLandscape fragmentation is increasingly undermining the capacity of ecosystems to provide services and benefits to humans. The development of a green infrastructure network can enhance the provision of ecosystem services connecting ecosystem features. We review and explore the concepts, methodologies, and applications that allow to analyse connectivity of green infrastructure networks and the role of spatial connectivity for supporting and maintaining ecosystem services. Together with connectivity, the quality, quantity, diversity, redundancy, and distances of ecosystem elements result to be important characteristics to support the provision of services. We report how spatial and connectivity-based methodologies (for example, network indices and spatial pattern analysis) can support characterisation and prioritization of green infrastructure networks for crucial interventions, both for preserving and restoring connection elements.

Introduction: Platelets play a fundamental role in the pathogenesis of acute coronary syndrome (ACS). The platelet count (PC) at hospital admission is easy to obtain, but whether thrombocytopenia or/and thrombocytosis impact long-term mortality (LTM) after ACS is unclear. Objective: To evaluate the effect of PC at hospital admission on LTM in patients with ACS. Methods: This retrospective cohort study included patients with the ICD-10 codes for unstable angina (I.20) and acute myocardial infarction (I.21, I.22). Thrombocytopenia was defined as a blood PC 450 G/L. Additional platelet indices which were tested included plateletcrit (PCT), the mean platelet volume (MPV), the platelet distribution width (PDW), and the platelet larger cell ratio (P-LCR). Data on all-cause death were obtained from the National Health Fund database. Results: The study included 3,162 patients with a median follow-up of 27.2 months (interquartile range 12.5–46.8 months; max 68.7 months). Patients with thrombocytopenia and thrombocytosis yielded a higher maximal analyzed 5-year mortality rate in comparison with normal PC patients (45.8 and 47.7 vs. 24.2%, respectively; p < 0.00001) which was mainly driven by higher deaths at 1–2 years after ACS. The 5-year LTM was also significantly higher in patients with abnormal PCT and MPV levels in comparison with patients with PCT and MPV within the normal range. Other platelet indices (PDW, P-LCR) were not associated with a worse outcome. The Cox proportional hazards model revealed that thrombocytopenia at admission was independently associated with higher LTM after ACS (RR 1.83; 95% CI 1.1–3.0; p = 0.01). Conclusions: Both thrombocytopenia and thrombocytosis at hospital admission in post-ACS patients are associated with a significant almost two times higher 5-year mortality rate.

The problem with limited venous access may occur in patients receiving long-term hemodialysis treatment with no possibility of arteriovenous access or in patients with cardiac implantable electronic device–related infection leading to the removal of cardiac implantable electronic device. We present a case report where both situations occur simultaneously. Using recent development in cardiac pacing—leadless cardiac pacemaker—we manage to overcome the vascular access problem. The described case emphasizes the necessity of multispecialty collaboration and gains of new pacing technology in patients who need placement of vascular access for hemodialysis and cardiac implantable electronic device where vascular access is scarce.

Purpose The purpose of this paper is to discuss how, despite increasing data availability from a wide range of sources unlocks unprecedented opportunities for disaster risk reduction, data interoperability remains a challenge due to a number of barriers. As a first step to enhancing data interoperability for disaster risk reduction is to identify major barriers, this paper presents a case study on data interoperability in disaster risk reduction in Europe, linking current barriers to the regional initiative of the European Science and Technology Advisory Group. Design/methodology/approach In support of Priority 2 (“Strengthening disaster risk governance to manage disaster risk”) of the Sendai Framework and SDG17 (“Partnerships for the goals”), this paper presents a case study on barriers to data interoperability in Europe based on a series of reviews, surveys and interviews with National Sendai Focal Points and stakeholders in science and research, governmental agencies, non-governmental organizations and industry. Findings For a number of European countries, there remains a clear imbalance between long-term disaster risk reduction and short-term preparation and the dominant role of emergency relief, response and recovery, pointing to the potential of investments in ex ante measures with better inclusion and exploitation of data. Originality/value Modern society is facing a digital revolution. As highlighted by the International Council of Science and the Committee on Data for Science and Technology, digital technology offers profound opportunities for science to discover unsuspected patterns and relationships in nature and society, on scales from the molecular to the cosmic, from local health systems to global sustainability. It has created the potential for disciplines of science to synergize into a holistic understanding of the complex challenges currently confronting humanity; the Sustainable Development Goals are a direct reflectance of this. Interdisciplinary is obtained with integration of data across relevant disciplines. However, a barrier to realization and exploitation of this potential arises from the incompatible data standards and nomenclatures used in different disciplines. Although the problem has been addressed by several initiatives, the following challenge still remains: to make online data integration a routine.

In January 2018, three leading European initiatives on climate services (CS) and disaster risk reduction (DRR) initiated a discussion on how the DRR community could be best served by new and emerging CS. The aim was to identify challenges and opportunities for delivery of effective operational disaster risk management and communication informed by an understanding of future climate risks. The resulting discussion engaged experts from civil protection, health, insurance, engineering and the climate service community. Discussions and subsequent reflections recognised that CS can strengthen all phases of the DRR cycle and that there are lessons to learn from experience that could enhance and demonstrate the value of CS supporting the DRR community. For this to happen, however, the supporting information should be relevant, accessible, legitimate and credible and engage both service supply and demand sides. It was also agreed that there was need for identifiable and credible champions recognised as providing leadership and focal points for the development, delivery and evaluation of CS supporting DRR. This paper summarises the identified key challenges (e.g. disconnection between CS and DRR; accessibility of relevant and quality-controlled information; understanding of information needs; and understanding the role of CS and its link to the DRR planning cycle). It also suggests taking advantage of the unique opportunities as a result of the increased coherence and mutual reinforcement across the post-2015 international agendas and the increasing recognition that links between public health and DRR can provide impetus and a focus for developing CS that support DRR.

Aims Improvement in left ventricular (LV) systolic reserve, including exertional increase in global longitudinal strain (GLS), may contribute to the clinical benefit from therapeutic interventions in heart failure with preserved ejection fraction (HFpEF). However, GLS is an afterload-dependent parameter, and its measurements may not adequately reflect myocardial contractility recruitment with exercise. The estimation of myocardial work (MW) allows correction of GLS for changing afterload. We sought to investigate the associations of GLS and MW parameters with the response of exercise capacity to spironolactone in HFpEF. Methods and results We analysed 114 patients (67 ± 8 years) participating in the STRUCTURE study (57 randomized to spironolactone and 57 to placebo). Resting and immediately post-exercise echocardiograms were performed at baseline and at 6-month follow-up. The following indices of MW were assessed: global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency. The amelioration of exercise intolerance at follow-up in the spironolactone group was accompanied by a significant improvement in exertional increase in GCW (P = 0.002) but not in GLS and other MW parameters. Increase in exercise capacity at 6 months was independently correlated with change in exertional increase in GCW from baseline to follow-up (β = 0.24; P = 0.009) but not with GLS (P = 0.14); however, no significant interaction with the use of spironolactone on peak VO2 was found (P = 0.97). Conclusion GCW as a measure of LV contractile response to exertion is a better determinant of exercise capacity in HFpEF than GLS. Improvement in functional capacity during follow-up is associated with improvement in exertional increment of GCW.

Aims Weight excess and insulin resistance predispose to heart failure. High sodium consumption may contribute to the development of cardiac impairment in insulin‐resistant individuals by promoting inadequate skeletal muscle microvascular perfusion response to insulin. We sought to investigate the association of dietary sodium reduction with muscle perfusion, insulin sensitivity, and cardiac function in overweight/obese insulin‐resistant (O‐IR) normotensive subjects. Methods and results Fifty O‐IR individuals with higher than recommended sodium intake were randomized to usual or reduced sodium diet for 8 weeks; 25 lean, healthy subjects served as controls for pre‐intervention measurements. Echocardiography and muscle perfusion were performed during fasting and under stable euglycaemic–hyperinsulinaemic clamp conditions. O‐IR patients demonstrated subclinical cardiac dysfunction as evidenced by lower left ventricular global longitudinal strain (GLS), e′ tissue velocity, and left atrial strain and reduced muscle perfusion. The intervention arm showed improvements in insulin resistance [glucose infusion rate (GIR)], GLS, e′, atrial strain, and muscle perfusion in fasting conditions, as well as improved responses of GLS and muscle perfusion to insulin during clamp. Significant interactions were found between the allocation to low‐salt diet and improvement in muscle perfusion on change in GIR at follow‐up (P = 0.030), and between improvement in muscle perfusion and change in GIR on change in GLS response to insulin at follow‐up (P = 0.026). Mediation analysis revealed that the relationship between the reduction of sodium intake and improvement in GLS was mediated by improvements in muscle perfusion and GIR (decrease in beta coefficient from −0.29 to −0.16 after the inclusion of mediator variables to the model). Conclusions The reduction of dietary sodium in the normotensive O‐IR population improves cardiac function, and this effect may be associated with the concomitant improvements in skeletal muscle perfusion and insulin resistance. These findings might contribute to refining heart failure preventive strategies.

Users of ensemble climate projections have choices with respect to how they interpret and apply the ensemble. A simplistic approach is to consider just the ensemble mean and ignore the individual ensemble members. A more thorough approach is to consider every ensemble member, although for complex impact models this may be unfeasible. Building on previous work in ensemble weather forecasting we explore an approach in-between these two extremes, in which the ensemble is represented by the mean and a reasonable worst case. The reasonable worst case is calculated using Directional Component Analysis (DCA), which is a simple statistical method that gives a robust estimate of worst-case for a given linear metric of impact, and which has various advantages relative to alternative definitions of worst-case. We present new mathematical results that clarify the interpretation of DCA and we illustrate DCA with an extensive set of synthetic examples. We then apply the mean and worst-case method based on DCA to EURO-CORDEX projections of future precipitation in Europe, with two different impact metrics. We conclude that the mean and worst-case method based on DCA is suitable for climate projection users who wish to explore the implications of the uncertainty around the ensemble mean without having to calculate the impacts of every ensemble member.

Introduction: Under physiological conditions, the myocardial extracellular matrix (ECM) is maintained by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). However, changes in the balance between MMPs and TIMPs can lead to pathological remodeling of the ECM, which contributes to cardiovascular and kidney diseases. The aim of our study was to assess levels of MMPs and TIMP-2 in patients with myocarditis and their relationship to renal function. Materials and Methods: Forty five patients with myocarditis who underwent CMR were included, comprising 11 with concurrent chronic kidney disease (CKD). Blood samples were obtained to assess serum levels of MMP-2, MMP-3, MMP-9, and TIMP-2. Results: Serum MMP-2, MMP-3, and TIMP-2 levels negatively correlated with the ejection fraction in patients with myocarditis, while MMP-3 levels correlated with longitudinal deformation (p < 0.05). Serum MMP-2, MMP-3, and TIMP-2 levels also negatively correlated with renal function, as assessed by the estimated glomerular filtration rate (eGFR) (p < 0.05). Patients with myocarditis and concurrent CKD had higher levels of MMP-2 and TIMP-2 than those without kidney damage. Conclusions: (1) We demonstrated that MMP-2, MMP-3, and TIMP-2 concentrations were related to left-ventricular ejection fraction, and MMP-3 levels correlated with longitudinal deformation, indicating MMPs play an important role in the post-inflammatory remodeling of the myocardium. (2) A negative correlation between the eGFR and MMP-2, MMP-3, and TIMP-2 and a positive correlation between creatinine and MMP-3 levels indicate the role of MMPs and TIMP-2 in renal dysfunction.

Background: Under physiological conditions, the myocardial extracellular matrix (ECM) is maintained by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). However, certain stimuli cause the upregulation of MMPs, which can lead to pathological remodeling of the ECM. We assessed serum levels of MMPs and TIMP-2 in patients with myocarditis and their relationship(s) to myocardial damage.Methods: In total, 45 patients with myocarditis who underwent cardiac magnetic resonance imaging were included, comprising 11 with concurrent chronic kidney disease (CKD). Blood samples were obtained to assess serum levels of MMP-2, MMP-3, MMP-9, and TIMP-2. Results: Serum MMP-2, MMP-3, and TIMP-2 levels negatively correlated with ejection fraction values in patients with myocarditis, while MMP-3 levels correlated with longitudinal deformation (pConclusions:1. We demonstrated serum MMP-2, MMP-3, and TIMP-2 concentrations were related to left ventricular ejection fraction, and MMP-3 levels correlated with longitudinal deformation, indicating MMPs play an important role in the post-inflammatory remodeling of the myocardium.2. The occurrence of other heart diseases was an important element in modifying the relationship between MMPs and the degree of myocardial damage.3. Chronic kidney damage in patients with myocarditis results in increased MMP activity. A negative correlation between eGFR and MMP-2, MMP-3 and TIMP-2, and a positive correlation between creatinine and MMP-3 levels, underlines the role of fibrosis in myocarditis with concomitant chronic kidney disease.

Probabilities of future climate states can be estimated by fitting distributions to the members of an ensemble of climate model projections. The change in the ensemble mean can be used as an estimate of the unknown change in the mean of the distribution of the climate variable being predicted. However, the level of sampling uncertainty around the change in the ensemble mean varies from case to case and in some cases is large. We compare two model averaging methods that take the uncertainty in the change in the ensemble mean into account in the distribution fitting process. They both involve fitting distributions to the ensemble using an uncertainty-adjusted value for the ensemble mean in an attempt to increase predictive skill relative to using the unadjusted ensemble mean. We use the two methods to make projections of future rainfall based on a large dataset of high resolution EURO-CORDEX simulations for different seasons, rainfall variables, RCPs and points in time. Cross-validation within the ensemble using both point and probabilistic validation methods shows that in most cases predictions based on the adjusted ensemble means show higher potential accuracy than those based on the unadjusted ensemble mean. They also perform better than predictions based on conventional Akaike model averaging and statistical testing. The adjustments to the ensemble mean vary continuously between situations that are statistically significant and those that are not. Of the two methods we test, one is very simple, and the other is more complex and involves averaging using a Bayesian posterior. The simpler method performs nearly as well as the more complex method.

Extreme weather and climate related events, from river flooding to droughts and tropical cyclones, are likely to become both more severe and more frequent in the coming decades, and the damages caused by these events will be felt across all sectors of society. In the face of this threat, policy- and decision-makers are increasingly calling for new approaches and tools to support risk management and climate adaptation pathways that can capture the full extent of the impacts. In the frame of the LODE DG ECHO project (https://www.lodeproject.polimi.it/), a GIS-based Bayesian Network (BN) approach is presented for the capturing and modelling of multi-sectoral flooding damages against future ‘what-if’ scenarios. Building on a risk-based conceptual framework, the BN model was trained and validated by exploiting data collected from the 2014 Secchia River flooding event, as well as other contextual variables. Moreover, a novel approach to defining the structure of the BN was performed, reconfiguring the model according to expert judgment and data-based validation. The model showed a good predictive capacity for damages in the agricultural, industrial and residential sectors, predicting the severity of damages with a classification accuracy of about 60% for each of these assessment endpoints. ‘What-if’ scenario analysis was performed to understand the potential impacts of future changes in i) land use patterns and ii) increasing flood depths resulting from more severe flood events. The output of the model showed a rising probability of experiencing high monetary damages under both scenarios. In spite of constraints within the case study dataset, the results of the appraisal show good promise, and together with the designed BN model itself represent a valuable support for disaster risk management and reduction actions against extreme river flooding events, enabling better informed decision making.

High-intensity and short-duration storms can generate pluvial floods in urban areas. Currently, 2D hydrodynamic models are recognised to be the best tool to simulate pluvial floods. The T-year synthetic design storm is usually assumed to generate the T-year pluvial flood. However, synthetic design storms cannot represent the variability in duration, precipitation and intensity temporal distribution of real storms that should be considered to account for their influence on water depths in pluvial floods. A more sound approach consists in estimating the T-year water depth in a given location from the frequency curve of water depths generated by a long series of possible rainfall events similar to the real storms.However, 2D hydrodynamic models require high computation times that are not well suited with stochastic simulations. The Safer_RAIN tool is a rapid hydrostatic flood model based on a filling-and-spilling technique that has been developed within the SAFERPLACES project funded by the EIT Climate-KIC (Samela et al., 2020). Depressions and links between them are identified from a digital terrain model. The continuity equation is used to simulate how depressions are filled and spill to downstream depressions. Infiltration is simulated by using a distributed implementation of the Green and Ampt model that accounts for ponding time.In this study, a stochastic methodology to delineate pluvial flood hazards is proposed in the Pamplona metropolitan area in Spain. First, the Safer_RAIN tool has been benchmarked by using spatially distributed high-resolution quantitative precipitation estimates (QPE) at time steps of 10 minutes for three real pluvial flood events. QPEs were obtained merging the data recorded at a set of automatic weather stations from the Spanish State Meteorological Agency (AEMET), the Regional Government of Navarre and crowdsourced networks, with continuous fields of radar observations. The Safer_RAIN tool has been benchmarked with the 2D hydrodynamic IBER model. In Barañáin, the results show a bias of -0.17–0.18 m and a RMSE of 0.22–0.49 m between water depths, as well as an accuracy correlation coefficient (ACC) of 0.87–0.99. In Zizur Mayor, the bias is -0.19–0.20 m, the RMSE is 0.29–0.55 m and the ACC is between 0.88 and 0.98.Second, a long set of 10 000 synthetic storms has been generated by using a stochastic rainfall generator based on a bivariate copula approach fitted to data recorded at four rainfall-gauging stations located close to the case study. The 10 000 synthetic storms generated with a Gumbel copula fitted to the real rainfall events have been used as input data of the Safer_RAIN tool. Safer_RAIN preprocessing was done in 112 seconds and each simulation lasted around 45 seconds. A Generalized Pareto distribution function was fitted to the 10 000 water depth values in each cell of the grid. Pluvial flood hazard maps were obtained by estimating the T-year water depth in each cell of the grid. Samela et al. (2020). Safer_RAIN: A DEM-Based Hierarchical Filling-&-Spilling Algorithm for Pluvial Flood Hazard Assessment and Mapping across Large Urban Areas, Water, 12, 1514.

Floods are a global hazard that may have adverse impacts on a wide-range of social, economic, and environmental processes. Nowadays our cities are flooding with increased occurrence due to more severe weather events but also due to anthropogenic pressures like soil sealing, urban growth and, in some areas, land subsidence. Frequency and intensity of extreme floods are expected to further increase in the future in many places due to climate change. The characterisation of flood events and of their multi-hazard nature is a fundamental step in order to maximise the resilience of cities to potential flood losses and damages. SaferPLACES employs innovative climate, hydrological and raster-based flood hazard and economic modelling techniques to assess pluvial, fluvial and coastal flood hazards and risks in urban environments under current and future climate scenarios.SaferPLACES platform provides a cost-effective and user-friendly cloud-based solution for flood hazard and risk mapping. Moreover SaferPLACES supports multiple stakeholders in designing and assessing multiple mitigation measures such as flood barriers, water tanks, green-blue based solutions and building specific damage mitigation actions.The intelligence behind the SaferPLACES platform integrates innovative fast DEM-based flood hazard assessment methods and Bayesian damage models, which are able to provide results in short computation times by exploiting the power of cloud computing.A beta version of the platform is available at platform.saferplaces.co and active for four pilot cities: Rimini and Milan in Italy, Pamplona in Spain and Cologne in Germany.SaferPLACES (saferplaces.co) is a research project founded by EIT Climate-KIC (www.climate-kic.org).

Introduction Although ticagrelor and prasugrel remain the standard antiplatelet treatments in acute coronary syndrome (ACS), numerous patients still present with indications for clopidogrel use. Aim We aimed to assess the levels of clopidogrel active metabolite and to evaluate the effect of the drug on platelet inhibition in patients with ACS as compared with those with stable coronary disease. Patients were assessed for the presence of the most common genetic polymorphisms that reduce the absorption (ABCB1) and activation (CYP2C19*2 and CYP2C19*3) of clopidogrel to exclude the effect of genetic variability on drug concentrations and activity. Material and methods This single-center, open-label, prospective study included 199 patients hospitalized due to ST-segment elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) in Killip class I–III, who underwent percutaneous coronary intervention. The control group included 22 patients with stable coronary artery disease. Results The mean (SD) levels of active clopidogrel were 17.1 (12.3) ng/ml in controls and 16.4 (12.0) ng/ml in the whole study group (p < 0.68). No differences were noted in clopidogrel levels between patients with STEMI and NSTEMI (mean (SD), 17.6 (2.3) ng/ml and 15.1 (11.5) ng/ml; p < 0.45) or between STEMI and NSTEMI groups and controls (p < 0.38 and p < 0.61, respectively). No effect of ABCB1 or CYP2C19 polymorphism was observed in the study subgroups. Conclusions We concluded that ACS does not affect the levels of clopidogrel active metabolite or platelet inhibition in patients in Killip class I-III with or without CYP2C19 or ABCB1 gene polymorphisms.